Doctors should consider prescribing a powerful antibiotic, doxycycline, to certain patients in order to prevent the spread of sexually transmitted infections (STIs), according to draft recommendations released Monday by the Centers for Disease Control and Prevention (CDC).
The CDC’s approach, called doxycycline post-exposure prophylaxis (Doxy-PEP), could be a significant step in combating the ongoing epidemic of STIs in the United States.
Early research has shown that taking doxycycline soon after potential exposure to bacteria during sexual activity can prevent infection. The current recommendation is to reserve doxycycline for treating diagnosed diseases, but the new approach could change that.
“Doxy-PEP is the first major new prevention intervention we have for STIs in decades,” said Dr. Jonathan Mermin, head of the CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention. Implementation of Doxy-PEP could prevent tens of thousands of infections.
The draft recommendations will be open for comments for 45 days before a final version is published next year.
Who should take Doxy-PEP?
The current recommendations are limited to gay, bisexual, and other men who have sex with men, as well as transgender women, as these groups are most affected by the STI epidemic. Specifically, the recommendation applies to individuals who have been diagnosed with at least one bacterial STI in the past year.
For those who would benefit the most from Doxy-PEP, doctors will be advised to prescribe a 200 mg dose of doxycycline to be taken within 72 hours after sexual activity.
While the CDC believes Doxy-PEP could be effective for other populations as well, further data is needed before making broad recommendations.
How long will it take to roll out Doxy-PEP?
Some health departments and sexual health clinics have already started offering Doxy-PEP independently. The CDC’s official recommendation could lead to wider adoption and coverage of the drug’s cost through public health budgets and insurance companies.
Doxy-PEP is relatively affordable compared to other medications, making it more accessible for implementation.
What are the risks of Doxy-PEP?
Implementing Doxy-PEP comes with its own costs for clinics, as they will need to monitor for side effects and screen for breakthrough infections. There is also concern about the development of antibiotic resistance.
The CDC plans to track the real-world implementation of Doxy-PEP and monitor for drug resistance.
“Long-term monitoring, evaluation, and additional studies will be key for us to update the guidelines as needed. There are important questions that remain regarding potential risks,” said Mermin.
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